Assessment of nutritional status in elderly patients with gastroesophageal cancer: A post hoc analysis.

Abstract

389 Background: Elderly patients with gastroesophageal cancer (GEC) frequently suffer from malnutrition due to tumor location and treatment-related toxicity. Malnutrition is associated with increased morbidity and mortality in this population. This study investigates the relationship between body mass index (BMI), Mini Nutritional Assessment (MNA) scores, unintentional weight loss (UWL), and chemotherapy toxicity while identifying key factors influencing nutritional status. Methods: This post hoc analysis utilized data from a prospective, multicenter study of patients aged 65 and older with all stages of GEC undergoing chemotherapy. Nutritional assessments were conducted using validated tools, focusing on BMI, MNA, and UWL over three months post enrollment. We defined malnourished patients as those with abnormal BMI (<18.5 or >30), low MNA (0-11), and significant UWL (≥10%). We analyzed associations between nutritional status and geriatric assessment comorbidities, depression score, functional status, cognition, hospitalization, treatment toxicity, and social support using Fisher’s exact tests. Results: Eighty-two patients were enrolled, with a median age of 73 years (range 65-91 years). The cohort was predominantly male (74%) and primarily presented with stage III-IV disease (82%), most receiving first-line therapy (79%). Primary sites included gastric (32%), esophageal (43%), and gastroesophageal junction (26%). Notably, 34% of patients had abnormal BMI, with 2 patients classified as underweight (BMI <18.5) and 19 as obese (BMI >30). Approximately 69% reported UWL, of 10% or greater. MNA scores indicated malnutrition in about 66% of patients (severe (0-7): 15 patients; moderate (8-11): 37 patients), while 31% scored within the normal range (12-14).Hospital admissions were significantly higher in patients with low MNA (33% vs. 3%; p=0.002) and UWL (29% vs. 8%; p=0.047). No significant correlations were observed between nutritional status and treatment type, treatment toxicity, or other geriatric assessment variables, including functional status and social support. Conclusions: MNA and UWL are effective indicators of nutritional status in elderly GEC patients, while BMI is not a reliable measure. Malnutrition significantly correlates with increased hospital admissions, highlighting the need for reliable tools to measure malnutrition to implement necessary interventions. Further research is required to explore the broader implications of malnutrition on treatment outcomes and quality of life in this vulnerable population.